The state of Patient safety in Uganda

Patient safety in Uganda is still a grey area. The health care system is characterized by low patient involvement and low awareness of patient safety. Patients are not empowered to engage health care providers regarding their conditions.

The doctors also consider empowered patients who ask them questions as difficult or stubborn and more often than not “difficult” patients are denied or frustrated throughout the process of receiving care. The patient is expected to be a passive receiver of care yet they know their disease better than the doctor does.

One patient in a workshop organised by UAPO, noted that,

“I had a health condition and though I was in much pain, I did not want to be treated by a general doctor, I wanted a female specialist, the doctor on duty told me that if I wanted to get better, I should allow being treated by any doctor, I insisted that I wanted a specialist, they asked me whether I wanted to get better or see a specialist, they got bored with me and said I had “lugezigezi” to mean difficult.

The doctor-patient ratio in Uganda is estimated at 1:25,725 and the nurse to patient ratio at 1:11,000. This has lowered the quality of health care given to patients and as such patients opt for more convenient ways of accessing care including self-medication through over the counter medicines and reliance on herbal medicines.

In a workshop conducted by Uganda Alliance of Patients Organisations (UAPO) and Community Health And Information Network in partnership with National Drug Authority and CIOMs, it was revealed that herbal and over the counter medicines have greatly harmed patients because they are not taken in the right doses and the herbal medicines are mixed with harmful substances.

Such practices have led to drug resistance with antibiotics and other medicines. It was also noted that the Pharmacovigilance system needs to be strengthened to protect patients from harm.

Patients have increasingly been victims of medical errors arising from negligence and negative attitudes of healthcare providers. The situation is made worse by unqualified personnel offering health care within the private health care system.

In 2018, a six-year-old girl was amputated as a result of a medical error. She had a fever and was taken to a private clinic, a drug was administered wrongly through her left hand and it got burnt leading to amputation. Such cases continue to happen to patients with little or no intervention at all from the regulatory authorities.

Additionally, healthcare is highly commercialized and providers are seeking for opportunities to maximize profits from people’s illnesses. This has caused some patients to undergo medical procedures which they don’t actually need and some have lost their lives in the process.

UAPO and its partners have continued to engage both patients and health care providers on patient safety both at the community and the national level. UAPO recognizes that achieving patient safety is a process and is continuing to engage health care professionals through training and workshops at health facility level and the engaging the Village health teams at the community level to ensure that no patient is harmed in the process of receiving care.